T1D is like a prickly cactus (literally and figuratively), but I've learned to embrace it, thorns and all.

Tag: dtech

When people notice my OmniPod insulin pump, the first question that I’m asked is “what IS that?”

After I explain that it’s my insulin pump, and it’s called a pod, the second question I’m asked is some variation of “how long does it last?”

The canned answer that I provide is something about having to change it every three days, because that’s how the OmniPod is advertised.

But I’ve used this pump for years now and never bothered to really test this three-day limit. I’ve known for a long time that my pod works a handful of hours after the expiration alarm starts chiming, but I wasn’t sure about exactly how many hours I had before a pod expired for good.

So, the other day, I decided to find out.

Have you ever made your pod last longer than 3 days? If so…are you a wizard???

My pod expired at 10:22 A.M. Since I prefer to change my pods in the evening, I figured it was the perfect time for this little experiment, assuming that the pod really would last me for the majority of the day.

And, well, it did! At 10:22 on the dot, the pod beeped at me to notify me that it was expired. And in the six hours after that, it would alarm every hour (on the 22nd minute) to remind me, time and time again, that it was expired. In the seventh hour – beginning at 5:22 P.M. – my PDM started chirping at me on and off every 15 minutes or so. First it was because I was running out of insulin, but then it was to really get the point across that my pod was expired!

I was determined to use every last drop of insulin in the pod, though, so I bolused for my dinner around 5:45 and I was pleased to discover that I got my full dose of insulin without any issues. As I was cleaning up after dinner, that’s when the signature OmniPod BEEEEEEEEEEEEEEEEEP went off as one blaring, unceasing alarm. I checked the time: 6:22 P.M.

So there was my answer. An OmniPod can last precisely 80 hours after you initially activate it for the first time (or in other words, 8 hours after you receive the first expiration message)…as long as it still has insulin in it. It’s definitely something good to know for sure now, because in the future, it might come in handy and help me avoid wasting precious insulin.

This post was originally published on Hugging the Cactus on February 18, 2019. I’m re-posting it today with some updates because I recently noticed this post gets a LOT of clicks – this topic is one that many people are curious about it. Read on for my two cents on whether or not bleeders are readers, and note that I haven’t updated this because my experience with bleeders remains the same…

I placed the new Dexcom G6 sensor on my abdomen, hovering my index finger above the large orange insertion button. I pressed it, exhaling as I felt the minute needle pierce my skin’s surface. I looked down, and started to rub the adhesive in circles to make sure it was stuck, when I saw blood. Not just a drop, but a decent-sized pool forming beneath the sensor. Before long, just about the entire surface of the white adhesive was soaked in red.

Yeah, this was going to be a no-go.

It’s pretty rare for me to experience blood at the site of a Dexcom sensor. If I had to put a number on it, I would say less than 10% of my insertions draw blood. An even smaller amount – like, 2% – have caused me to bleed as much I did in the scenario described above. But I know I’m not alone in my bloody sensor experiences – it’s something that many other T1Ds who use a Dexcom have gone through.

There’s a bit of debate, though, that I’ve noticed in the past on Twitter threads and Instagram posts. What to do with a bleeder? Keep it and assume that it’ll read blood sugars normally? Or change it immediately and call Dexcom for a replacement?

Are bleeders readers? Or does it depend?

Do you think that bleeders are readers?

I’m going to go with…it depends.

Obviously, in that situation I described in the opening of this post, I decided that it wasn’t a good idea to keep the sensor on my body. There was too much blood and I didn’t trust that it would adhere well to my body. I didn’t know how long it would take for the blood to stop (only a few minutes, but still), and I couldn’t be sure that it wouldn’t mess up my readings. On top of that, I wasn’t trying to stain my clothing, if I could help it.

So in that circumstance, I did change my sensor right away, and was glad that the second try resulted in a much cleaner, blood-free insertion. I called Dexcom, explained what happened to the customer support representative, and got a replacement sensor mailed to me.

However, just about any other time I bleed upon a sensor insertion, it tends to be a minuscule amount of blood. I usually don’t even notice until it’s time to replace the sensor, and there’s a bit of dried blood left on the site. Other times, I’ll see small beads of blood forming underneath the spot where the transmitter snaps in. And there’s been a couple of occasions that I’ve bled a fair amount and been totally unaware of it until I caught my reflection in the mirror and noticed the blood staining the white adhesive. And in all of those cases, I’ve kept the sensor on for the full ten days, without noticing any discrepancies in my readings.

All that considered, in my inexpert opinion, I think that bleeders usually are readers and that they’re safe to continue wearing. Of course, there will be exceptions, like when there’s just too much blood to salvage the sensor. But every time I’ve kept using a bloody sensor, I’ve had the same amount of success with its functionality…so yes, I think that for me, bleeders are indeed readers.

So you want to try your first continuous glucose monitor. Or maybe you’re ready to leave behind multiple daily injections and switch to insulin pump therapy. Whichever diabetes device you’re looking to start using, there are some questions you’ll probably want to have answers to before decide that now’s the time to introduce new diabetes technology into your daily routine.

The following is a compilation of the questions that I thought long and hard about (literally for years) and that I wish I’d thought long and hard about before I made the transition to the OmniPod insulin pump.

Am I ready for it? It took me 17 years before I decided that I was ready to try an insulin pump. 17 freakin’ years!!! I spent most of that time being too afraid of introducing such a drastic change to a routine I’d had down pat for such a long period of my life. There are times when I wish I’d gone onto my insulin pump sooner, but ultimately, I’m glad that I wasn’t swayed by my family or doctors to go on it before I truly felt ready. By the time I started using my OmniPod, I had the maturity, responsibility, and emotional intelligence that I felt that I needed for an insulin pump.

Will I be able to afford it? Obviously, this isn’t a question that I wondered about when I was younger, but it’s one of the first things that comes to mind as an adult on her own health care plan. We all know that diabetes supplies are expensive, and it seems that the more technologically advanced something is, the more money that has to be forked over in order to obtain it. This isn’t right or fair, but it’s a simple truth and an important one to think about before choosing one pump or continuous glucose monitor over another.

Why do I want to start using it? I wanted to start using my OmniPod because my mom experienced great success when she started using it. And I decided to get a Dexcom CGM because I fell in love with the technology after undergoing a trial period with my endocrinologist. In both situations, I felt very much in control of my decision to start using these devices and I didn’t really listen to anyone else’s opinions. But I am very aware of the fact that social media and real-life friendships with other people with diabetes can often sway people in different directions. After all, if I saw a post on Instagram from a dia-influencer who was singing the praises of a Tandem T:slim pump, then I might seriously start thinking about switching to it (this has actually happened to me). But the bottom line is to think about the why – will this device enhance quality of life for me? Will diabetes be easier to manage with it? Will it help me achieve my A1c and/or blood sugar goals? Do I need to add something new to my routine because I’m feeling burnt out by doing things the same way all the time? Knowing why I wanted to use an OmniPod or a Dexcom CGM made me feel that much better during the whole process of learning how to use them – I felt like I had clear goals that would help me navigate the integration of these new technologies into my daily routine.

Me, being a goofball with my two favorite diabetes devices.

Will I be comfortable wearing it 24/7? This is a big one! Pods, pumps, and CGMs are very visible, and it can be jarring to go from being “naked” to having bumps and lumps underneath clothes that can get caught on doorknobs, chairs, and the like. Personally, the benefits of my OmniPod and Dexcom outweigh something like this which is a bit superficial, but that doesn’t mean it’s not something to think about. But it’s also worth thinking about comfort and what is least painful when it comes to insulin delivery, so that’s why this is an important question to ask.

Do I know anyone else using it who can provide feedback from a patient’s perspective? I’ve talked about this before, but I’m not sure when, if ever, I would have seriously considered using the OmniPod if my mother hadn’t tried it first. The fact that we both have diabetes has probably made us a little closer and strengthened our bond, so if there’s anyone’s opinion that I’m going to trust when it comes to something like this, then it’s hers. I can actually remember her first few weeks on the OmniPod – in which she learned a lot of valuable lessons – and how pleased she was with it once a few months with it elapsed. She taught me the ins and outs of the OmniPod when I started to use it, and I’d argue that her advice was more helpful than that of my diabetes educator. So I’d advocate gathering opinions from family and friends (if either is applicable) or the diabetes online community before going on a new diabetes device, in addition to the research component below…

Have I done enough research on it? …Like any smart shopper, it’s crucial to really consider all options and research them thoroughly, especially when it comes to the top contender. I definitely did not complete sufficient research before going onto the OmniPod or Dexcom; rather, I trusted that they were just right for me. If I were to switch to something else tomorrow, though, you can bet that’d I’d spend a lot of time scouring the web for every last bit of information on the device so I could make the most informed decision possible.

New diabetes technology can be both scary and exciting. But more than anything else, it can really make life with diabetes much more carefree, and I’m glad that in this day and age there are so many options available to people with diabetes that continue to be technologically impressive.

Like many other people with diabetes, I wear two devices on my body at all times: my insulin pump (my pod) and my continuous glucose monitor (CGM). And I’m often asked whether or not these little gadgets are painful.

Fortunately, the answer is that most of the time, they aren’t. I rarely feel it when my CGM sensor or my insulin pod’s cannula pierce my skin, which makes the whole experience of wearing them a lot more comfortable – and much less dreadful when it’s time to rotate sites.

Speaking of sites and pain, though, I admit that there are some sites that, for me, tend to work better than others. The following are the different locations I use for my pod and CGM sensors, in order of what tends to be best to the worst.

My stomach is my preferred spot for my pod AND my sensor.

Stomach: This is the site at which I have the best insulin absorption, so it’s a clear winner for me when it comes to my pod placement. I also find that it almost never hurts when I press up against the pod (e.g., when I roll over in bed in the middle of the night) when it’s on my belly. The same is true for my CGM sensors, which also seem to be the most accurate when they’re placed on my abdomen. I guess there’s a reason why the stomach site is the only one recommended by the FDA for the Dexcom CGM (which is what I use)!

Lower back: I have yet to try my CGM here, but I often place my pod on my lower back without issue. This site can be trickier to navigate because if I forget that my pod’s there when I’m getting dressed in the morning, I can come precariously close to accidentally knocking it off – and I have in the past. Plus, the pod can rub up against me in an unpleasant way when I’m working out; specifically, doing any sort of abdominal exercise on the ground. But it’s not something I can’t tolerate, and the insulin absorption in this location is just too good in general for me to pass over it altogether.

Upper arm: I wear my pod and CGM on my upper arms sometimes, but they don’t always adhere well for some reason. Getting dressed can be even more problematic for me if I forget that my sites are on my arms – I’ve totally ripped off pods and sensors when I’ve been taking off and putting on clothing. And for a long time, my CGM sensors would make me bleed when I inserted them in my upper arm. I never figured out why, and the problem seems to have gone away, but it definitely made me a little more wary about using my arms as a site (PLUS any devices I wear on my arms are highly visible, and I don’t always like it when people stare at them).

Thigh: Hands-down, the worst site for my pods are my thighs. For starters, wearing denim jeans – especially if they’re skinny jeans – are such a feat when wearing a thigh pod. The fabric pushes up against the pod in such a way that I prefer wearing dresses, skirts, or leggings for the three days that I have a thigh pod just so I can be more comfortable. And speaking of comfort, it’s tough for me to get into a cozy sleeping position when I have a thigh pod because I like sleeping on my stomach sometimes, and there’s just too much pressure up against my pod when it’s on my thigh. And for me, it seems that insulin absorption just isn’t great on my thighs (maybe because they’re on the muscular side). BUT, I will say…I recently tried a CGM sensor on my thigh for the first time and I didn’t hate it! The accuracy was good and it wasn’t in the way as much as a thigh pod (I keep wanting to type “tide pod”) would be. I’ve only had it on my leg for a few days now so I don’t know yet how the adhesive will hold up, but I’ll find out.

Spots I haven’t tried yet (but want to): On social media, I’ve seen people wear Dexcom sensors on their forearms (eek), upper butt cheek (tee-hee), and even on their calves. And pod placement can get even wilder with spots in the center of the back (HOW can people reach back there) and, um, the upper-breast area (one word: ouch). While I don’t think I’ll ever work up the courage to try some of those spots, I am curious about others.

The bottom line is, though, that the sites that work best for me might not work as well for you. (The same thing can be said for my worst sites.) But it is important to remember, above all, the importance of rotating sites…even though I’m clearly not a huge fan of pods on my legs, I’ll still suck it up and place them there because I know that I should be careful of scar tissue buildup.

It just makes the pod-and-sensor-change days that much more pleasant when I can move them from a disliked site to a favorite site, anyways.

Choosing an insulin pump therapy can be stressful and overwhelming, especially if you’ve never pumped before.

Factors like tubed vs. tubeless, whether or not your insurance will cover a given pump, ease of use, reservoir capacity, and many others all play into the big pump decision…

…if you’re like most (logical) people.

But if you’re me, then you count on pretty much one thing when making the choice: familiarity. I solely relied on the fact that someone I knew and trusted used the OmniPod and had a positive experience with it, and that person is my mother. On top of that, I waited a solid 2-3 years after she started to use it before it was my turn, because I wasn’t willing to even think about trying it until I could feel fairly confident that I would even like it myself.

I may or may not have changed my PDM’s display screen for the sake of this picture.

Luckily, I’ve been on it for just over five years now without any major issues. While I do love it more than I ever liked multiple daily injections, I do wish I had thought it over some more before just going with it…especially now that there are other insulin pumps out there with some amazing features. I know that the manufacturer of the OmniPod, Insulet, has some great upgrades in the works, but it can be hard to wait for them.

If I could go back in time, I’d definitely do more research before semi-idly deciding that the OmniPod is right for me. Of course, I could make the switch to a new insulin pump in the future…but if and when I do decide to try something else down the road, I know I’ll make much more of an effort to really learn everything I can about my options before committing to a new piece of diabetes technology.

12:55 A.M. I wake up from a deep sleep to the sound of my CGM going off: My blood sugar had just gone above my high threshold. I silence the alert and reach for my PDM so I can give myself a small correction bolus. But it’s not in its usual spot on my nightstand.

12:56 A.M. I tumble out of bed and wander into the living room. Surely, I left my PDM somewhere out here. I dig through my backpack, check the coffee table, and look for it on the counter tops in the kitchen. I can’t find it in any of those locations.

12:57 – 1:00 A.M. I’m searching all over the apartment, like a mad woman now. I’m checking in between couch cushions, inside cabinets, and underneath furniture at a lightning-fast pace. My heart is beating rapidly as I wonder where the actual eff my PDM could be. I shake my sleep and bemused partner awake, fill him in on the situation, and enlist his help in the search. He only has a vague idea of what the PDM looks like (I have too many devices for him to be able to distinguish the difference between them) and isn’t much help, but he does offer a tip: Check the car.

1:00 – 1:03 A.M. I run down four flights of stairs and into the parking garage where my boyfriend’s car is parked. Maybe it fell out of my backpack on our way to trivia at a restaurant earlier that evening? I rifled through the passenger seat, checking underneath it and even in the backseat, but no luck.

A post all about a terrifying 20-minute period in which my PDM was…MIA.

1:04 – 1:07 A.M. I practically break out in a cold, panicked sweat as I contemplate the possibility that I took my PDM out at the restaurant and it’s still there. I knew for a fact that I hadn’t used my PDM for anything since I’d eaten dinner hours before at the apartment, but it was worth calling the restaurant to see if they’d found anything. I called, knowing the odds of anyone answering at this hour were slim…only to be proven wrong! I was relieved when a man picked up, and I hastily explained to him the situation. I provided a description of my PDM and waited with bated breath while he searched the area in which my team had sat to play trivia.

1:08 – 1:11 A.M. Crushing disappointment crashes over me like stormy ocean waves as the man tells me, after a prolonged search, that he couldn’t find my PDM. I felt like I’d been punched in the gut. Numbly, I recited my contact information over the phone, thanked him for his time, and hung up. I was beyond panicked now. My boyfriend was asking me about a contingency plan and all I wanted to do was scream at him, my OmniPod IS my contingency plan!!!!!!!! I start formulating a plan to drive to the restaurant first thing in the morning to search the premises myself, as well as call Insulet and beg them to overnight a new PDM. Maybe I would just have to stick to manual injections the entire next day, though I had no idea what I’d do about long-acting insulin since the Lantus sitting in the fridge expired months ago.

1:12 – 1:14 A.M. My mind was in overdrive and I refused to give up right then and there. I was absolutely certain that I hadn’t taken my PDM out since my dinnertime bolus. But since I did go out that night, there were really only one of three places it could be: the apartment, the car, or the restaurant. It definitely wasn’t in the apartment, which I’d searched so thoroughly that it looked like a tornado had whipped through it, but it was worth searching the car one more time…just to be positive.

1:15 A.M. I make my way back down to the parking garage. I turn my cell phone’s flashlight feature on and scan the seats carefully, peeking under and over and around every possible surface…I didn’t see a damn thing. Defeated, I turned to close the passenger side door when, out of the corner of my eye, I saw a gray object wedged between the door would be when it was slammed shut and the seat. It was practically camouflaged, that’s how well it blended with its surroundings. It was…MY PDM!!!

“Relieved” doesn’t begin to describe how I felt. “Elated”, “victorious”, and “exhausted” are all better descriptors. I ran back up to the apartment, told my boyfriend, and breathed a deep sigh, glad that the entire episode had a happy ending. We settled back into bed, though I lay there staring at the ceiling for a long time afterwards. If I hadn’t double checked the car, my boyfriend would’ve just driven off to work the next day, both of us oblivious to the fact that my PDM was there. I would’ve wasted time trying to track it down at the restaurant and calling Insulet, and there probably would’ve been a lot more frustration felt and tears shed.

But thank goodness it didn’t come down to that.

The end results of the missing PDM episode was 1) losing a decent night of sleep, 2) feeling an urgent need to establish a better contingency plan, and 3) feeling an even more pressing need to install a tracking device in that damn PDM, stat…because that thing is just too easy to lose.

In it, a friend of mine was talking about how she “soaks” her CGM sensors. Instantly, I was confused: What the heck did she mean by that? Soaks them in what, hot water or some other liquid?

Contrary to the connotation of the word “soaking”, this does not mean you’ll be submerging your CGM in any sort of liquid.

Within seconds, her definition of “soaking” became much clearer. “Soaking” a CGM sensor means inserting a fresh sensor hours before you intend to activate it. Rather than giving your sensor just two hours to warm-up, you’re giving it 4-6 hours so it can supposedly provide much more accurate readings immediately after the warm-up period has ended.

I was interested in this practice because I’ve definitely experienced sensors that were off for several hours post-insertion/warm-up. Sometimes, it even takes a full day for a sensor to start reporting accurate numbers, and I wouldn’t exactly call that efficient.

While I haven’t had the guts to actually try sensor soaking yet – I’d like to sometime in the near future – I’ve been doing some research on it so I’m fully prepared to try it whenever I’d like. Here are some questions I had about the process, and the answers I’ve found to them:

Q: Doesn’t this mean that you’re wearing two sensors at once?A: Yes. But it’s only for a short window of time, until the old sensor expires and it’s time to activate the new one; in other words, for the full soaking period.

Q: How long should I let a new sensor soak?
A: According to what I’ve found online, it seems that 4 to 6 hours is the sweet spot for soaking. It’s basically doubling or tripling the built-in warm-up period that all sensors must go through, so I can see how this might contribute to improving immediate accuracy.

Q: How do I protect the new sensor if it doesn’t have a transmitter snapped in it for several hours?
A: The reason why I haven’t tried soaking yet is because I was worried about wearing a sensor that didn’t have a transmitter snapped in it. But I found some photos online of people who wore transmitter-less sensors with stretchy, self-adhesive wrap tape to protect the nook in which transmitters rest for the soaking period. It’s smart to protect that space, because in theory, it could be vulnerable to catching on clothing or other surfaces. Plus, tape like that is really easy to remove without damaging the sensor in the process.

Q: What changes about the sensor activation process when it’s finally time to start the new soaked sensor?
A: My research leads me to believe that nothing really changes at the end of the soaking period/when it’s time to activate the soaked sensor. All that will be needed is the sensor code so it can be properly activated within the receiver/Dexcom app. So the most important thing you can do at the very start of the soaking period is hold onto your sensor code/store it somewhere safe so you’ll be able to enter it at the end.

Q: So…why would anyone bother trying this again?A: My understanding is that it all relates back to making sure a fresh sensor is as accurate as possible once it’s activated. I can’t tell you how many times I’ve put on a new sensor, only to discover a few hours after it has warmed up that it’s off by 40 or 50 points – and that just doesn’t cut it. So I don’t think there’s any harm in me giving sensor soaking a shot one of these days. I just have to remember to do it, and have the patience to wear three devices at once (my pod, the soon-to-expire sensor, and the new soaking sensor).

Have you tried soaking? If so, please drop a comment and let me know your thoughts on it – and be sure to tell me if I missed any key steps in my research!